Chiropractor's Blog

New research reveals that women could be neglecting their back or neck health as they take twice as long, six weeks on average, to seek help for their pain, while men take just three. The consumer research also found that women, on average, develop back or neck pain at the age of 27, six years younger than men and experience it more regularly. Despite this, a quarter of women have never visited a health professional for their pain.

In addition, the findings from the British Chiropractic Association reveal that more than a third of women are turning to over the counter medication as a first port of call, 12% more than their male counterparts, ignoring simple fixes such as exercise and stretching which can prevent and improve back or neck pain. In contrast, men are most likely to turn to their GP when initially experiencing pain.

Whilst women are least likely to seek help, the BCA found that overall over a third (34%) of Brits would wait a month or more to seek professional help for back or neck pain. Moreover, one in ten Brits would continue to suffer in silence, not seeking help at all.

​Simple lifestyle changes, such as stretching and incorporating more movement into your daily routine, can be an easy and effective way to keep the back pain at bay, yet only 11% of men and women make these changes to their routine when they start to experience back pain.

This trend for women to ‘keep calm and carry on’ is also reflected in their delay in seeking help for other health conditions, with men seeking professional help for joint pain, strains and headaches more quickly than women.​For the majority of back pain sufferers the discomfort of back and neck pain can be eased or prevented by maintaining a strong, active body which is able to cope with the demands made of it, as described in a recent series of paper on back pain in The Lancet.

Top tips for women with back or neck pain:• Keep moving: Almost half (47%) of female respondents pointed to sitting still for a long time as a key trigger for their pain. If you are required to sit in one position for extended periods of time, at work or on a long drive for example, try to take breaks to walk around, stretch and move your joints and muscles every 30-60 minutes.• Hit the gym: Incorporating moderate exercise into your lifestyle will help you to build a stronger body that is better placed for dealing with the demands you make of it. If pain is preventing you from exercising, try a form of exercise, such as swimming, which will put less pressure on the joints while allowing your body to move.• Stretch it out: Stretching can be a beneficial way to keep your joints and muscles active. The BCA’s Straighten Up programme of simple exercises can be incorporated into your daily routine to promote movement, strength and flexibility in the spine.• Get a good night’s sleep: After a busy day sleep is essential, so I suggest taking some simple steps to ensure you sleep in a comfortable position. The Sleep Council recommend replacing your mattress every seven years and when you do, pick one that provides the right support for your body type and pillows that suit your sleeping position.• Keep it light: Almost a third (32%) of women cite that carrying their bag is a key trigger for their back or neck pain. If you are one of those people, then think about trying a different bag or about what you’re loading it up with! Choosing a bag that can be worn as a backpack or across the body may help to spread the load. Keeping your bag light and emptying it of unnecessary items each day can also help to prevent unnecessary weight.

​Consumer research carried out between 28/02/2018 and 07/03/2018 on a sample of 2,066 UK adults aged 16 + on behalf of the British Chiropractic Association.

I've pinched this from the BBC but I thought it was well enough written that I didn't have to bother! We can't even swim in the sea now!

Matt

Swimming in the sea substantially increases the chance of developing stomach bugs, ear aches and other illnesses, researchers have found.The University of Exeter Medical School and Centre for Ecology and Hydrology carried out the study.It concluded, compared to non-sea swimmers, the likelihood of developing an earache increases by 77% and for a gastrointestinal illness rises by 29%.As well as swimming, the risks also apply to water sports, such as surfing.Researchers reviewed 19 studies linking sea bathing to illness from the UK, US, Australia, New Zealand, Denmark and Norway. They analysed results from more than 120,000 people."In high-income countries like the UK, there is a perception that there is little risk to health of spending time in the sea," said Dr Anne Leonard."However, our paper shows that spending time in the sea does increase the probability of developing illnesses, such as ear ailments and problems involving the digestive system, such as stomach ache and diarrhoea."We think that this indicates that pollution is still an issue affecting swimmers in some of the world's richest countries."Research supervisor Dr Will Gaze said: "We don't want to deter people from going into the sea, which has many health benefits such as improving physical fitness, wellbeing and connecting with nature."However, it is important people are aware of the risks so they can make informed decisions."Dr Gaze said most people will recover from infections with no medical treatment but they can prove more serious for vulnerable people, such as the very old or very young.He added: "We have come a long way in terms of cleaning up our waters, but our evidence shows there is still work to be done."We hope this research will contribute to further efforts to clean up our coastal waters."

With the temperatures hitting some icy lows, perfect your ‘ice walk’ this March with top tips from the British Chiropractic Association.

Snowy and icy roads and pavements mean potentially hazardous conditions underfoot and a rise in injuries caused by slips and falls. It is quite natural, therefore, for us to be wary when walking outdoors and adopting our ‘ice walk’; the problem is that an unnatural walking posture could cause as many problems as the icy conditions themselves.

Tim Hutchful, from the British Chiropractic Association, offers some top tips to stay safe and adopt a better ‘ice walk’:

Best foot forward– It is a good idea to have two pairs of shoes, one for walking in the ice and snow, the other for indoors or whilst driving.– Waterproof or other, lined shoes are preferable as are thermal socks, as these items will help keep your feet warm. Cold, numb feet are less able to sense and adapt to changing conditions.– Footwear should have a solid and large, raised treads on the sole; essential for maximising your grip on the ice.– Shoes with support features are important – walking shoes with a firm ankle support are ideal as they help prevent you ‘going over’ on your ankle and help you feel more stable in slippery conditions. If shoes have laces, they should be firmly laced to give a close fit without limiting the circulation.What to avoid…..Wellingtons can be practical, but they often don’t give enough support and can be difficult to take off. Also avoid walking outside in leather or other, smooth soled shoes.

Top Gear– Clothing should be warm and allow you to move freely. Anything that impedes you from walking ‘normally’ could make you more prone to falling over or lead to you walking in an unnatural way.

Be Prepared– There are things you can do to prepare yourself for better balance. Standing on one leg, as an exercise, is a great way to help improve your balance.– When you are out and about, keeping your hands out of your pockets (use gloves) so that you can use your arms for better balance is a great idea too.– Watch out for parts of the pavement that may have been in shadow or under trees, where there is more likely be black ice, but make sure you pay attention to what is ahead too!

Falling GracefullyIf you do fall, try and curl up and ‘roll’ with the fall and stay relaxed, this will minimise any jarring to your body. Whilst it may be an automatic reaction, try to avoid putting your hands out to save you – this may cause wrist injuries.

Keep Your WitsTry to avoid alcohol. Not only will you be more prone to feeling the adverse effects of the cold (because alcohol causes loss of body heat) but it may also cause you to take risks that you wouldn’t normally do and, of course, make you more unsteady on your feet. Keep topped up with warm drinks to keep your temperature up.

Ten days ago, I went on my annual trip to the Royal College of Chiropractors Winter Conference in London. A lot of it was dull, very dull.

However, at the conference was a speaker named Ann Gates who talked about the importance of exercise for all sorts of health conditions. These were things that I already knew but that I had almost forgotten.

Her main point was that if exercise was a drug that you could get from your GP, if would be hailed as a miracle. A drug that reduces all causes of death by 30%!

The other information that I liked was the amount of exercise that different groups of people require. As you can see from the pictures below, 0-5 year old's need 3 hours of moderate intensity exercise per day. 5-18 year old's need 60 minutes per day and everyone over 18 years of age needs 150 minutes per week MINIMUM.

So what is moderate exercise I hear you cry? Well, examples of moderate exercise include:

​As the rather excellent NHS website states "Moderate activity will raise your heart rate and make you breathe faster and feel warmer. One way to tell if you're working at a moderate level is if you can still talk, but you can't sing the words to a song."

I would strongly encourage everyone to visit the NHS website I mentioned above by clicking HERE. The page you will be taken to is for adult recommendations but there are links to the children's versions too.

As you will see when you visit the NHS website, their are different ways to get your quota in. You can do 75 minutes of vigorous exercise instead. As a general rule, you can half the amount of time required if the exercise is vigorous.

The recommendations for adults also state that strength training should incorporated into our routines. However, the easiest way to think of it really is to do 30 minutes of some sort of exercise every single day. That way, you've got it covered.

I think the most important thing to take away from all of this is that most of us could do a little more than we do currently. As the picture at the top of this article shows, the benefits of exercise really are incredible and we can all access those benefits with some fairly small changes.

The second most common question I am asked is: Should I use ice or heat for my pain?

Just to be difficult, the answer is both!

This piece of advice is as helpful as a chocolate teapot. Therefore, I will try to explain when to use ice and when to use heat in the following paragraphs.

The first thing to think about is that cold reduces inflammation which reduces swelling, redness and soreness. Heat increases new blood flow into the area which brings with it nutrients and inflammatory chemicals. This promotes healing and relaxation. So, now that we know what ice and heat do, we can start to understand when to use them.

If you have a sharp, catching pain that almost takes your breath away, you are probably experiencing inflammatory pain. Most commonly this comes from joints and occasionally tendons and ligaments. You would almost certainly need to use ice to reduce the inflammation and thereby reduce the pain. I recommend using an ice pack for around 15 minutes at a time. 20 minutes is okay if you are thick set are using it on your lower back. 5 minutes is enough if you are using ice on your hand or foot as their isn't much padding for the ice to permeate. Remember to wrap the ice pack in a tea towel or pillow case as freezer burn is not nice. When you are finished, pop the ice pack into the freezer for 30-40 minutes and then repeat. If it's easier, just use the ice pack once an hour for 15 minutes until the sharp pain has gone. I do understand that real life means that may not be possible. Just do what you can, the more the merrier.

If you have an aching, dull pain that seems to be ever present and annoying, you are probably experiencing muscle tightness or over-activity. You would be better served using heat to relax the muscles and flood them with nutrients so that they can heal. I recommend using heat in the same way as ice, except that with heat, it's harder to overdo it. If you left a heat pack on for 30-40 minutes nothing bad would happen. If you left ice on for too long, you can damage the tissues. Use heat in the same way as the ice, once an hour until things have improved. Incidentally, if you have a long-term (chronic) condition such as wear and tear in your joints (osteoarthritis), heat can be used to ease the pain and stiffness associated with this.

So, in summary, the sharper and newer (acute) the pain, the more likely it is that you should use an ice pack. The duller, more achey and longer lasting (chronic) the pain, the more likely it is that a heat pack would be best.

Acute and sharp = ice.Chronic and achey = heat.

We have packs that can be frozen or microwaved available in both clinics for £5. They last around five years and can be constantly re-used.

For a bit of fun, the first person who correctly tells me the most common question I am asked wins a brand new ice/heat pack.

A new report by Ofcom has found that one in three adult internet users has opted for a digital detox. As well as a detox, being smart when using tech can ease some of the physical issues that can come up.

For example, one way to help get a good balance of technology use is to consider the benefits of making your bedroom a tech free zones, as this could lead to improved quality of sleep and better posture, thus reducing physical effects of technology use on the back and neck.

In 2014, research from the British Chiropractic Association (BCA) found that more than half (54%) of the UK population were are using mobile phones in bed and nearly half (49%) confessed to using a laptop or a tablet at bedtime.

Technology has become integral to our lives but when it comes to bedtime it is having negative repercussions on our lifestyles and bodies. When people use laptops or mobile phones in bed, they tend to forget their posture, hunch over the screen and leave their spine unsupported which can damage posture and cause back or neck pain.

The BCA's research in 2014 showed that nearly half (48%) of people can’t sleep due to back or neck pain but technology could actually be exacerbating the problem. Many of my patients who can’t sleep will resort to a laptop or a mobile phone to help them get to sleep, for example to watch a film, but the reality is this could further prevent them from sleeping.

The light given off by screens stimulates the brain making us feel more awake and what’s more, when people use technology in bed, they often don’t pay attention to their postures which can cause pain and keep them awake. We’re urging people to make their bedrooms tech-free zones and see what benefits can come from this.

THE BCA’S TOP TIPS FOR MAKING YOUR BEDROOM A TECH-FREE ZONE...• Check it out then pack it in: If you find yourself tempted to check your emails one last time before bed, try doing this in the living room or the kitchen then switch off your laptop or mobile phone and pack the device away in your bag ready for work the next morning.

• Keep the TV out of sight, out of mind: Try and avoid having a television in your bedroom as if it’s not there, you won’t be tempted to watch it. Instead, try to limit yourself to having a television only in communal areas of your home.

• Forget the mobile phone dock, use an alarm clock: With mobile phones now being integral to our lives, try not to rely on it to wake you up too. Invest in a cheap but effective old-fashioned alarm clock which means that you don’t need to keep you mobile phone in the bedroom. If your partner struggles to switch off it could be the ideal stocking filler.

• Using tech in bed? Don’t forget your head: Looking down at screens in bed means your neck won’t be supported and the weight of your head leaning forward will put pressure on your back, which may cause back or neck pain. If you are using tech in bed, make sure your back is supported with a pillow and the device is propped up so it’s at eye level.

AND WHEN YOU ARE USING TECH DURING THE DAYTIME... • Be aware of your posture when using mobile devices on the go, don’t hunch over small screens and ensure you are never in the same position for a prolonged period.

• When sitting in front of your PC or laptop, sit in a chair that provides full support for your spine and make sure your shoulders, hips and knees face the same direction.

• Your seat should be adjusted so that your feet are flat on the ground and knees bent, but with a slope from your hips to your knees. You should end up with your hips higher than your knees and your eyes level with the top of the computer screen. You may need to put the screen on a stand, book or ream of paper to bring it to the right height.

• The head is a heavy weight, so sitting with it forward of your body puts unnecessary strain on your neck and back, so always sit with your head directly over your body.

• Avoid sitting in the same position for more than 40 minutes, less if possible. When you do take a break, walk around and stretch a little.

• If you carry a laptop use a rucksack design laptop case, carry it on both shoulders and adjust the straps so that the bag is held close to your back.

• Try out new gadgets before you buy them to make sure they’re comfortable to use and spend time setting them up in a way that works well for you.

• Don’t carry too many items in your bag all the time. Get in the habit of only packing what you need each day and avoid ‘doubling up’ on your tech (i.e. camera and smartphone) if at all possible.

• When using your mobile, smartphone, laptop or tablet whilst sitting down, including on your commute, take the time to break position on a regular basis and stretch your arms, shrug your shoulders and move your fingers around as this helps to keep the muscles more relaxed.

We are currently in the midst of a summer of sporting excitement and entertainment with something for everyone: Euro 2016, Rugby test matches, test cricket, Tour de France, US PGA Golf and Wimbledon to name a few and of course, not forgetting the Olympics in Rio de Janeiro. Make sure you are not the injury worry this sporting summer and take care of your posture.

Sitting for long periods can trigger back pain and with endless hours or sporting coverage in the offing, some will be more at risk than ever of becoming couch potatoes!

Our lifestyles are sedentary enough but, during televised sporting events, people spend even more time sitting down. Lack of exercise is our worst enemy and we should avoid sitting for prolonged periods of time, as sitting incorrectly puts almost twice as much pressure on the back than when standing.

Prolonged sitting isn't the only health hazard. Sport fans will argue that jumping up to celebrate a gold medal win or berate a referee is an involuntary action but, doing it too quickly may be more harmful than sitting down for prolonged periods. Going from a fixed posture when sitting down to quickly jumping up on your feet in excitement could be potentially damaging.

Follow this simple advice from the British Chiropractic Association (BCA) to have a pain free summer of sport:• Try to ensure that you change position every twenty minutes; stand up and move around (An excuse to grab a refreshing beverage)!• Make sure you are active during half time; there is plenty of light exercise you can do during the 15 minute break.• Don't slump, sit right back into the seat, so your back is fully against the back of the chair/sofa.• Drink Up! - As much as possible, try drinking water instead of beer, tea and coffee; it will keep you hydrated and help you concentrate on what is happening.• All this variety of sport may inspire you to get out and try it yourself, which is the perfect way to keep active over the long summer evenings.

I was asked the other day about maintenance care. In fact I was asked if I would recommend it.

I instantly felt a blog post coming on!

Chiropractors have long held the belief that regular monthly follow up treatments even after you have reached maximum improvement are just as helpful for the spine as the regular services you provide for your car.

​Pain

In a recent study reported in the Journal of Manipulative and Physiological Therapeutics, after intensive care for one month, thirty long-term back pain patients were randomised to receive either no follow-up care, or maintenance chiropractic treatments at three week intervals for a nine month period.

Both groups continued to have significant improvement in their pain scores throughout the follow-up period. However, only the group receiving maintenance care during the follow-up period retained their improvement in disability nine months later.

In other words, when patients opt for maintenance care they generally notice their pain and stiffness less often and experience fewer flare-ups.

Overall health

Can maintenance adjustments really help our overall health and well-being? In case studies, patients report improvement in both mental and physical well being when they continue maintenance care. Also, other chiropractic services, such as advice regarding diet, exercise, posture, and stress management, have a more meaningful impact on overall health and well-being when continued during follow-up visits.

In the Journal of Manipulative and Physiological Therapeutics it was reported that based on a seven year period, patients utilising chiropractic maintenance had:

A 60.2% reduction in hospital admissions

A 59.0% decrease in hospital days

A 62.0% drop in outpatient surgeries and procedures

An 85% decrease in pharmaceutical costs when compared with conventional medicine within the same geography and during the same time frame.

Once per month?

Do patients have to keep coming monthly to get best results? Well, because chiropractors look at their patients as individuals that respond differently to treatment approaches, it does depend on several factors.

There may be some especially older individuals with significant arthritis that get best results when having treatment more often than monthly. On the other hand a younger individual that is fit and has no prior history of problems may be able to return every two or three months for a “tune-up” and still get great results. Still another individual may get great results for a while then get put under a lot of stress, stop exercising and see their problems worsen. They may then need a temporary increase in the frequency of their follow-up care.

No two patients are exactly alike. However, for a lot of patients that have a prior history of significant spinal problems, a monthly treatment seems to provide sustained relief and help prevent recurrence. In fact, I go to my chiropractor in Horsham once per month for maintenance and prevention.

What if it’s not for me?

If you have read through this information and have decided that maintenance care isn’t for you, that’s okay. You can always call us on an ‘as and when’ basis whenever you need us. If you have any questions, please ask.

The other day whilst I was wasting my life on Facebook, I came across a Groupon advert for a chiropractor in Brighton who was offering x-rays as part of their deal.

Three commonly asked questions popped into my mind:

Does every chiropractic patient need an x-ray?

Does anyone really need an x-ray?

Are x-rays dangerous?

1. Does every chiropractic patient need an x-ray? In a word, no.

Many years ago, some chiropractors believed that to see which spinal joints were "out of alignment" an x-ray was necessary. However, it has since been proven (again, years ago) that the "out of alignment" theory is somewhat flawed. If you really had a true "spinal misalignment" that was visible on x-ray, you would probably need something a lot more invasive than a chiropractic treatment to sort it out for you!

These days it's more accurate to say that the spinal joints are "stiff or restricted" in their movements, rather than "out of alignment". In other words, the problem is with the amount of movement in the joints, not their position. To find out which joints are stiff and restricted we simply have to ask you to move in certain positions and use our hands to check the movement manually. Stiffness and restriction cannot be assessed using a static picture (x-ray/MRI). As most chiropractic patients' pain is caused by this sort of stiffness and restriction, any form of imaging is simply not necessary, especially when you consider the radiation dosage associated with x-rays.

2. Does anyone need an x-ray? Sometimes, yes.

The only patients that need an image taken are those whose case history suggests cancer, a bone or joint infection, a fracture (broken bone) or full thickness cartilage/ligament/tendon/muscle tear from trauma, an inflammatory bone or joint disorder or osteoarthritis in the hip, knee or shoulder (but not the spine). If this was the case an MRI scan would be a far better bet in most cases as all the soft tissues (cartilage, ligaments, tendons, muscles etc) are seen on the scan. On an x-ray, only bones are visible which is fine for a suspected fracture or hip, knee and shoulder osteoarthritis but not a great deal else.3. Are x-rays dangerous? No but they do give you a dose of radiation which is not particularly healthy. Being exposed to X-rays carries a theoretical risk of triggering cancer at a later date, as does exposure to background radiation.

Everyone is exposed to sources of natural radiation throughout their life. Natural radiation is sometimes known as background radiation. Sources of background radiation include:

Radon – a naturally occurring radioactive gas found in low levels in the atmosphere.

Cosmic rays – a type of radiation that originates from space (from the sun and stars).

The earth – soil and rocks contain various radioactive materials that have been present since the earth was formed; these contribute to our exposure, as do building materials made from soil, rocks and stones.

Food and water – for example, nuts, bananas, red meat and potatoes all contain tiny traces of radiation.

One spinal x-ray is the equivalent of a few months' to a year's worth of background radiation and has a 1 in 10,000-100,000 chance of causing cancer. When x-rays are taken, two or three are usually taken to make sure everything in the area is seen. So, those figures need to multiplied or divided accordingly.

So in summary, x-rays aren't usually required for back or neck pain, are occasionally useful for suspected fractures or osteoarthritis of the hip, knee or shoulder (not the spine) and aren't particularly good for you. I would say in the last twelve months, I have sent five to ten people for x-rays.

My personal opinion is that anyone offering an "x-rays for everyone" policy perhaps needs to update their understanding of anatomy and physiology. There are only a handful of reasons why an x-ray should be considered and back and neck pain are not among them.

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